Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Customized Veterans Group

Organization Addiction (Substance Use Disorder) Counselor · NPI 1184435802

Customized Veterans Group is an Addiction (Substance Use Disorder) Counselor in Memphis, Tennessee. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

578 Harrell St
Memphis, TN 38112-2932
Phone: (901) 907-0640
Fax: (901) 255-0758
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X

Record details

NPI number1184435802
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Antwane Bohanon — Chief Executive Officer · (808) 453-0018
NPI enumeratedJanuary 14, 2025
Last updated in NPPESJanuary 14, 2025
Certification dateJanuary 14, 2025
Mailing address578 Harrell St, Memphis, TN 38112-2932

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